Looking out for the emotionally vulnerable in the COVID world

By:  Bunni Dybnis, MA, LMFT, CMC

Our lives have changed dramatically as COVID-19 becomes the focus of most everything. The news, warnings, restrictions, instructions, double messages, shortages, politics, and financial implications are never-ending. For most, the initial chaos, fears, panic, and confusion settle in as we adapt to our new world.  For a small number, the major impact of their situation, combined with their adaptive coping styles is more of a concern.  Those over sixty-five will have more of a challenge.

I have three long-time friends I will call Jane, Irene, and Cathy.  Jane and Irene were diagnosed with cancer in early March, when the COVID virus was starting to make front-page news.  They are both over 70. They both are undergoing life-sustaining chemotherapy upon the recommendation of their medical teams.  They both have supportive families, close friends, and financial security.  Undeniably, they both have reason to be concerned.

Jane, after the initial shock, is responding with appreciation of her doctors, children, and others who are reaching out. She continues to be socially and mentally engaged reading, Netflix bingeing, enjoying virtual cultural events, and fine dining take-outs. She is active on social media and communicating regularly with friends. She is thrilled that her hairdresser was able to style a wig she will wear when her hair falls out.

Irene ‘s response is different. She has taken to her bed and spends her days in self-isolation.  She refuses to engage with her many supports.  She is both physically and emotionally exhausted. Irene’s family is at a loss.  The history of responding with resilience by Jane, and despair by Irene, separates the two.

Another friend, Cathy, can’t break the cycle of obsessing on every bad detail of the news. The anxiety has lead to sleeplessness and erratic eating.  Cathy is immobilized by symptoms of depression, unable to work, catch up, or engage in other activities that could reduce the stress.  Unlike Jane, Irene and Cathy are in need of further interventions to assist them in the challenges they face.

I thrive on social interaction. Being widowed with children long out of the house, my network has extended far beyond the walls of my home. Continuous contact with family, a solid network of old friends that are like family, close business colleagues and new relationships have kept me engaged.

The biggest challenge has been adjusting to social distancing that is now the reality.  Like most, I have figured out a way to cope and adjust to a new normal: Zooming, FaceTime, DIY projects, Crafts, Book clubs, Support groups, Happy hours, Lectures, Adult learning, Walking, Texting, Connecting with old friends, Organizing, Staying on top of business and personal obligations, Walks in the neighborhood, Cleaning closets, Cooking, and reaching out – keep me busy and energized.

All these activities don’t make up for face-to-face contacts, dining out, canceled vacations, and cultural outings.  One day that will all return.

Being able to cope with loss and change is the norm.  The grief or adjustment process is well documented.  Over eight-in-ten people will go through a series of emotions, and over time will move toward resolution and healing.  The self-identified introverts who no longer have to meet the regular social demands might even thrive. The vulnerability and restrictions on those over 65 is a cause for added stress. It may take a little longer and be more challenging, but most will learn to adapt and move forward.  Beyond age, there are some additional risks and challenges for family caregivers, the frailest, and most physically and cognitively impaired. They must be identified and provided additional assistance or inventions as needed.

Those older adults residing in assisted living, and skilled nursing facilities are truly under threat of exposure to COVID-19 and the high risk of mortality. Extreme responses to this threat should not be considered mal-adaptive in anyway.  The legitimate fears and isolation from loved ones must be attended to.  Many of the frailest and most vulnerable are not computer literate. They also may have sight or hearing deficits.  These folks can’t take advantage of the tools that many of us have taken for granted. There is an excellent article in the New York Times that speaks some of the ways to assist.

Many families are introducing technology when there is an opportunity. It can be a time to be creative.

  • For those whose family member is in a senior care facility, and outside visitors are not allowed, staff can act as a surrogate introducing an Ipad, computer, or other technology.
  • Checking in by phone, old-fashioned letter writing, greeting cards, and outside window visits from loved ones can all make a difference.
  • IPods with generational appropriate music and art kits can bring enjoyment.
  • Don’t forget the normal maintenance to enhance sensory enjoyment.
    • Keeping hearing aids and corrective lenses current is essential.
    • Volume enhancing telephones and other adaptive devices are available online.
    • There is a huge network of senior service providers and professionals who specialize in working with seniors available to assist.

Unfortunately, there is still a stigma around the on-going fatigue of caregivers and front line workers. The chronic nature of symptoms for those with mental health needs are often ignored until a crisis hits. Those with a history of depression, anxiety, or related disorders are particularly affected in these times of danger, chaos, and change.  Proactive intervention by medical or mental health professionals should be considered for those at high risk. The accelerating use of telemedicine makes these interventions easier to assess than ever before.

It is no longer just the other.  Grieving what has been taken from us, affects us all.  Older adults are more vulnerable to both short term and long-term consequences of not having the coping skills to maintain their health and emotional well being.  If there is a concern an Aging Life Care Manager can provide an evaluation of the situation and provide options for intervention (www.aginglifecare.org)

ABOUT THE AUTHOR: Bunni Dybnis, MA, LMFT, CMC is the President and Founder of Aging Life Matters.   She has spent the last twenty-five years supporting families and their trusted advisors addressing the often-complex issues of aging, end of life and family dynamics.  A Fellow in the Leadership Academy of the Aging Life Care Association Bunni has received multiple awards for her leadership, participation and achievements in geriatric care from both the Association and organizations both national and local.

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